Preoperative Computerized Tomography and Magnetic Resonance Imaging of the Pancreas Predicts Pancreatic Mass and Functional Outcomes after Total Pancreatectomy and Islet Autotransplant

Michael C. Young, Jake R. Theis, James S. Hodges, T. B. Dunn, Timothy L. Pruett, Srinath Chinnakotla, Sidney P. Walker, Martin L. Freeman, Guru Trikudanathan, Mustafa Arain, Paul R. Robertson, Joshua J. Wilhelm, Sarah J. Schwarzenberg, Barbara Bland, Gregory J. Beilman, Melena D. Bellin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives Approximately two thirds of patients will remain on insulin therapy after total pancreatectomy with islet autotransplant (TPIAT) for chronic pancreatitis. We investigated the relationship between measured pancreas volume on computerized tomography or magnetic resonance imaging and features of chronic pancreatitis on imaging, with subsequent islet isolation and diabetes outcomes. Methods Computerized tomography or magnetic resonance imaging was reviewed for pancreas volume (Vitrea software) and presence or absence of calcifications, atrophy, and dilated pancreatic duct in 97 patients undergoing TPIAT. Relationship between these features and (1) islet mass isolated and (2) diabetes status at 1-year post-TPIAT were evaluated. Results Pancreas volume correlated with islet mass measured as total islet equivalents (r = 0.50, P < 0.0001). Mean islet equivalents were reduced by more than half if any one of calcifications, atrophy, or ductal dilatation were observed. Pancreatic calcifications increased the odds of insulin dependence 4.0 fold (1.1, 15). Collectively, the pancreas volume and 3 imaging features strongly associated with 1-year insulin use (P = 0.07), islet graft failure (P = 0.003), hemoglobin A1c (P = 0.0004), fasting glucose (P = 0.027), and fasting C-peptide level (P = 0.008). Conclusions Measures of pancreatic parenchymal destruction on imaging, including smaller pancreas volume and calcifications, associate strongly with impaired islet mass and 1-year diabetes outcomes.

Original languageEnglish (US)
Pages (from-to)961-966
Number of pages6
JournalPancreas
Volume45
Issue number7
DOIs
StatePublished - Aug 1 2016

Fingerprint

Pancreatectomy
Autografts
Pancreas
Tomography
Magnetic Resonance Imaging
Chronic Pancreatitis
Insulin
Atrophy
Fasting
C-Peptide
Pancreatic Ducts
Dilatation
Software
Transplants
Glucose

Keywords

  • TPIAT
  • chronic pancreatitis
  • islet
  • islet autotransplant
  • pancreas
  • total pancreatectomy

Cite this

@article{0f935757c84246649cfcbc3753f94e79,
title = "Preoperative Computerized Tomography and Magnetic Resonance Imaging of the Pancreas Predicts Pancreatic Mass and Functional Outcomes after Total Pancreatectomy and Islet Autotransplant",
abstract = "Objectives Approximately two thirds of patients will remain on insulin therapy after total pancreatectomy with islet autotransplant (TPIAT) for chronic pancreatitis. We investigated the relationship between measured pancreas volume on computerized tomography or magnetic resonance imaging and features of chronic pancreatitis on imaging, with subsequent islet isolation and diabetes outcomes. Methods Computerized tomography or magnetic resonance imaging was reviewed for pancreas volume (Vitrea software) and presence or absence of calcifications, atrophy, and dilated pancreatic duct in 97 patients undergoing TPIAT. Relationship between these features and (1) islet mass isolated and (2) diabetes status at 1-year post-TPIAT were evaluated. Results Pancreas volume correlated with islet mass measured as total islet equivalents (r = 0.50, P < 0.0001). Mean islet equivalents were reduced by more than half if any one of calcifications, atrophy, or ductal dilatation were observed. Pancreatic calcifications increased the odds of insulin dependence 4.0 fold (1.1, 15). Collectively, the pancreas volume and 3 imaging features strongly associated with 1-year insulin use (P = 0.07), islet graft failure (P = 0.003), hemoglobin A1c (P = 0.0004), fasting glucose (P = 0.027), and fasting C-peptide level (P = 0.008). Conclusions Measures of pancreatic parenchymal destruction on imaging, including smaller pancreas volume and calcifications, associate strongly with impaired islet mass and 1-year diabetes outcomes.",
keywords = "TPIAT, chronic pancreatitis, islet, islet autotransplant, pancreas, total pancreatectomy",
author = "Young, {Michael C.} and Theis, {Jake R.} and Hodges, {James S.} and Dunn, {T. B.} and Pruett, {Timothy L.} and Srinath Chinnakotla and Walker, {Sidney P.} and Freeman, {Martin L.} and Guru Trikudanathan and Mustafa Arain and Robertson, {Paul R.} and Wilhelm, {Joshua J.} and Schwarzenberg, {Sarah J.} and Barbara Bland and Beilman, {Gregory J.} and Bellin, {Melena D.}",
year = "2016",
month = "8",
day = "1",
doi = "10.1097/MPA.0000000000000591",
language = "English (US)",
volume = "45",
pages = "961--966",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",
number = "7",

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TY - JOUR

T1 - Preoperative Computerized Tomography and Magnetic Resonance Imaging of the Pancreas Predicts Pancreatic Mass and Functional Outcomes after Total Pancreatectomy and Islet Autotransplant

AU - Young, Michael C.

AU - Theis, Jake R.

AU - Hodges, James S.

AU - Dunn, T. B.

AU - Pruett, Timothy L.

AU - Chinnakotla, Srinath

AU - Walker, Sidney P.

AU - Freeman, Martin L.

AU - Trikudanathan, Guru

AU - Arain, Mustafa

AU - Robertson, Paul R.

AU - Wilhelm, Joshua J.

AU - Schwarzenberg, Sarah J.

AU - Bland, Barbara

AU - Beilman, Gregory J.

AU - Bellin, Melena D.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Objectives Approximately two thirds of patients will remain on insulin therapy after total pancreatectomy with islet autotransplant (TPIAT) for chronic pancreatitis. We investigated the relationship between measured pancreas volume on computerized tomography or magnetic resonance imaging and features of chronic pancreatitis on imaging, with subsequent islet isolation and diabetes outcomes. Methods Computerized tomography or magnetic resonance imaging was reviewed for pancreas volume (Vitrea software) and presence or absence of calcifications, atrophy, and dilated pancreatic duct in 97 patients undergoing TPIAT. Relationship between these features and (1) islet mass isolated and (2) diabetes status at 1-year post-TPIAT were evaluated. Results Pancreas volume correlated with islet mass measured as total islet equivalents (r = 0.50, P < 0.0001). Mean islet equivalents were reduced by more than half if any one of calcifications, atrophy, or ductal dilatation were observed. Pancreatic calcifications increased the odds of insulin dependence 4.0 fold (1.1, 15). Collectively, the pancreas volume and 3 imaging features strongly associated with 1-year insulin use (P = 0.07), islet graft failure (P = 0.003), hemoglobin A1c (P = 0.0004), fasting glucose (P = 0.027), and fasting C-peptide level (P = 0.008). Conclusions Measures of pancreatic parenchymal destruction on imaging, including smaller pancreas volume and calcifications, associate strongly with impaired islet mass and 1-year diabetes outcomes.

AB - Objectives Approximately two thirds of patients will remain on insulin therapy after total pancreatectomy with islet autotransplant (TPIAT) for chronic pancreatitis. We investigated the relationship between measured pancreas volume on computerized tomography or magnetic resonance imaging and features of chronic pancreatitis on imaging, with subsequent islet isolation and diabetes outcomes. Methods Computerized tomography or magnetic resonance imaging was reviewed for pancreas volume (Vitrea software) and presence or absence of calcifications, atrophy, and dilated pancreatic duct in 97 patients undergoing TPIAT. Relationship between these features and (1) islet mass isolated and (2) diabetes status at 1-year post-TPIAT were evaluated. Results Pancreas volume correlated with islet mass measured as total islet equivalents (r = 0.50, P < 0.0001). Mean islet equivalents were reduced by more than half if any one of calcifications, atrophy, or ductal dilatation were observed. Pancreatic calcifications increased the odds of insulin dependence 4.0 fold (1.1, 15). Collectively, the pancreas volume and 3 imaging features strongly associated with 1-year insulin use (P = 0.07), islet graft failure (P = 0.003), hemoglobin A1c (P = 0.0004), fasting glucose (P = 0.027), and fasting C-peptide level (P = 0.008). Conclusions Measures of pancreatic parenchymal destruction on imaging, including smaller pancreas volume and calcifications, associate strongly with impaired islet mass and 1-year diabetes outcomes.

KW - TPIAT

KW - chronic pancreatitis

KW - islet

KW - islet autotransplant

KW - pancreas

KW - total pancreatectomy

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U2 - 10.1097/MPA.0000000000000591

DO - 10.1097/MPA.0000000000000591

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VL - 45

SP - 961

EP - 966

JO - Pancreas

JF - Pancreas

SN - 0885-3177

IS - 7

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